Because you probably don’t need a probiotic supplement

Of the trillions of microbes that live in your gut, most are friendly, helping absorb nutrients, optimize immune function, prevent disease, and keep bad bacteria in check. You want to get as many of these good bacteria as possible. Probiotics offer a way to boost your count. Think of them as reinforcements, brought in from the outside in the hopes that they’ll join forces with other beneficial microbes in your gut.

Humans have consumed probiotics for thousands of years through fermented foods, but supplements have emerged in the last century to deliver high concentrations of specific strains, such as Lactobacillus acidophilus AND Bifidobacterium bifidum. Probiotic supplements are hugely popular, generating $759 million in U.S. sales in 2020. If you’re looking to improve your gut health, you may have considered taking a probiotic supplement, but experts warn against doing so without guidance from a gut health specialist.

[American College of Gastroenterology] guidelines don’t recommend the widespread use of probiotic supplements, even for most gastrointestinal conditions, says Vanessa Mndez, MD, a triple-certified gastroenterologist. She notes that supplements may be beneficial in specific cases, such as to help treat infections or restore the gut microbiota after a course of antibiotics, but in other cases they may be ineffective, at best.

In general, Mndez recommends getting probiotics the old-fashioned way: from fermented plant foods, such as tempeh, miso and kimchi. A 2016 review published in Critical reviews in food science and nutrition analyzed a number of studies and concluded that for healthy people, probiotic foods appeared more effective than supplements; the researchers speculated that this might have to do with a buffering effect of foods to help probiotics pass through the gut.

But all probiotics, whether from food or supplements, will only establish themselves in environments that are hospitable to their strain. Otherwise, they will act more like tourists. Consuming the microbes themselves can have a temporary effect, Mndez says. The real long-term benefit comes from giving your existing beneficial microbes what they need to thrive and multiply. This is where prebiotics come into play.

Prebiotics: premium fuel for a healthy gut

Most of what we eat is broken down and absorbed in the small intestine, but fibrous nutrients known as prebiotics move into the large intestine and serve as food for beneficial microbes. When microbes break down prebiotics, they release biochemicals that perform important tasks in the body (more on that later).

While only a few types of resistant starch and fiber have been confirmed as prebiotics, experts expect the list to grow. Ten years ago, the entire prebiotic conversation revolved around inulin, so people started focusing on Jerusalem artichokes and asparagus. But we now know that consuming a wide variety of plants is much healthier than consuming Jerusalem artichokes and asparagus alone, says Will Bulsiewicz, MD, MSCI, board-certified gastroenterologist and author of The fiber recipe book. I think the important point is that all plants, without a doubt, contain prebiotic fiber.

Bulsiewicz and Mndez point out that probiotic supplements can be beneficial in certain medically supervised settings and probiotic-rich foods can help bring diversity to the gut microbiome, but prebiotic foods are the foundation of sustainable gut health.

The great thing about a whole foods, plant-based diet is that you can consume both [prebiotics and probiotics]says Mndez. Fill your plate with foods higher in fiber and you’ll be fueling a healthy gut microbiome.

Food manufacturers are hip to the growing interest in prebiotics. The next time you’re at the grocery store, you’ll likely see granola bars or sugary cereals that have prebiotic claims on their labels. Don’t buy it. They’re still ultra-processed foods, Bulsiewicz explains. Instead, he recommends choosing dietary fiber in its native state, i.e. whole plant foods.

What are Postbiotics?

One of the most exciting developments in the world of gut health is the discovery of postbiotics: short-chain fatty acids (SCFAs) and other biochemical byproducts that gut microbes release when they consume prebiotics. SCFAs such as butyrate, acetate and propionate perform important functions throughout the body, reducing inflammation and insulin resistance, killing cancer cells and maintaining the integrity of the intestinal barrier. They also appear to help synthesize neurotransmitters and affect the brain in other profound ways.

For a long time, we thought the intestinal tract was essentially just a hollow tube that churned food and absorbed nutrients, Mndez says. Then we discovered that gut microbes are indeed involved in the process of breaking down fiber. And recently, we’ve realized that they actually do much more than that.

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